Complications of Midface Swing for Management of Juvenile Nasopharyngeal Angiofibroma

Abstract

Introduction Access osteotomies provide direct exposure to inaccessible areas of the deep part of craniofacial skeleton for treating pathologies involving vital structures. The use of maxillary swing approach for gaining wide access to the nasopharynx, infratemporal fossa, parapharyngeal space, middle fossa of skull base. Though the maxillary swing requires transfacial incision for wide exposure but with careful handling the scar is minimum and this approach can be used in young people. Materials and Methods Surgical resection is carried out following preoperative embolization of the involved feeder vessels. Total 16 cases were considered for this study. Results This article highlights cases successfully treated in our institution, the mention of complications associated with the cases along with management. Conclusion Maxillary swing is a good approach for getting access to the deep pathologies like JNA.

Robotic transmaxillary approach to the lateral infratemporal fossa: A preclinical cadaveric study using a next‐generation single‐port robotic system

“…Complications and outcomes of open approaches have been studied by high‐volume centers and include temporary facial paresis (25%), permanent temporal branch paralysis (5%), 25,28 permanent conductive hearing loss (75%), temporary trismus, 26 and cerebrospinal fluid leak (5.26%) 27 . Maxillary swing or facial translocation approaches to the ITF are associated with facial scars, paresthesia, oroantral fistula, and malocclusion 2930,31 . From the current literature, it is estimated that 40%–72% of primary ITF tumors are benign 25 .…”

Extended endonasal approach versus maxillary swing approach to the parapharyngeal space

“…The only area in which the maxillary swing approach went beyond the boundaries of the endoscopic endonasal approach was the oropharynx because the maxillary swing opens the palate. This is particularly useful to manage the retropharyngeal lymph nodes, which are nearly always at or slightly lower than the level of the palate . Otherwise, the endoscopic endonasal approach undoubtedly provides broader boundaries than those of the maxillary swing approach.…”

Access to the skull base - Maxillary swing procedure - Long term analysis

“…Although a number of complications have been described in literature associated with the procedure,[ 19 20 ] it is imperative to comprehend that the patient's outcome is more significantly related to complete resection of the lesion, and this should not be compromised by inappropriate exposure. [ 12 ]…”